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Top Drawer > Common OB Medications > Flashcards

Common OB Medications Flashcards

1
Q

Pitocin (Oxytocin)
uses

A

induction of labor
control postpartum uterine bleeding
after Suction D&C

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2
Q

Pitocin (Oxytocin)
direct & indirect action

A

Indirect: increases intracellular Ca

direct: stimulates oxytocin receptor on the myometrium

~antidiuretic

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3
Q

Pitocin (Oxytocin)
contraind

A

fetal distress
unfavorable fetal positions
previous uterine rupture

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4
Q

Pitocin (Oxytocin) systemic
effects

A

flushing
brady/tachycardia
hyper/Hypotension

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5
Q

Pitocin (Oxytocin)
dose

A

Dose: 10-40 U in 1000cc LR

Post Csxn: keep uterus tight/small to prevent bleeding (KVO ~100ml/h)

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6
Q

Pitocin (Oxytocin)
onset & duration

A

onset: immediate
duration: within 1 hour

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7
Q

Pitocin (Oxytocin)
does not work until….

A

12-14 W gestation

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8
Q

Methergine (Methlyergonovine)
cannot be given via which route?

A

NEVER given IV

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9
Q

Methergine (Methlyergonovine)
drug class/substance type

A

Semisynthetic ergot alkaloid

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10
Q

Methergine (Methlyergonovine)
MoA

A

directly: acts on smooth muscle
-increases uterine motor activity
-increase tone, rate, and amplitude of contraction

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11
Q

Methergine (Methlyergonovine)
CV effects

A

alpha stimulation: Arterial vasoconstriction

inhibits endothelial derived relaxation factor release

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12
Q

Methergine (Methlyergonovine)
Contraindications

A

severe HTN
Preg induced HTN (PIH) (>140/90)
cardiac disease

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13
Q

Methergine (Methlyergonovine)
dose

A

0.2 mg IM every 2-4 hours (max 5 doses)

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14
Q

Methergine (Methlyergonovine)
onset and duration

A

onset: 2-5 min
duration: about 3 hours

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15
Q

Hemabate (Carboprost)
identity

A

Synthetic analogue of prostaglandin F2

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16
Q

Hemabate (Carboprost)
MoA

A

stimulates uterine contraction
increase of myometrial calcium
stimulates smooth muscle of GI tract to cause diarrhea

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17
Q

Hemabate (Carboprost)
effect on temperature

A

Increase in temperature possibly due to effect on hypothalamic thermoregulation

(can increase 2 degrees)

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18
Q

Hemabate (Carboprost)
contraindications

A

Airway constriction and wheezing
increase CO, BP and PVR (constriction of vascular smooth muscle)

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19
Q

Hemabate (Carboprost)
dose
onset
duration

A

Dose: 250 mcq IM repeated every 15-45 min (max 8 doses)

onset: immediate
duration: 2 hours

20
Q

Misoprostol (Cytotec)
identity

A

Synthetic prostaglandin E1

21
Q

Misoprostol (Cytotec)
uses

A

uterine atony
abortions
cervical ripening
peptic ulcer disease

22
Q

Misoprostol (Cytotec)
dose

A

1-2 tablets buccal (200 mcq each)

rectally and vaginally (By OB)

23
Q

Misoprostol (Cytotec)
onset & 1/2L

A

onset: rapid

half life: 20-40 min

24
Q

Magnesium Sulfate (MgSO4)
uses

A

prevent eclamptic seizures (decrease incidence of seizure by 50 %)
stop premature labor (tocolytic)

25
Q

Magnesium Sulfate (MgSO4)
MoA

A

-Inhibit ACh release at NMJ
-Mild vasodilator: decreases uterine activity = increase uterine blood
-dilates liver beds and kidneys to increase function
-decreases SVR

26
Q

Magnesium Sulfate (MgSO4)
potentiates …….

A

nondepolarizers and depolarizers
(prob dont need to change dose tho)

27
Q

T/F
Magnesium Sulfate (MgSO4) does not cross the placenta

A

False
neonate may show signs of respiratory depression, apnea and decreased tone

28
Q

Magnesium Sulfate (MgSO4)
possible negative effects
(not including toxicity)

A

Can cause pulmonary edema
? correlation with chorioamnionitis

29
Q

Magnesium Sulfate (MgSO4)
dose

A

4 grams over 20 min
drip: 2-3 grams/ hour

30
Q

Magnesium Sulfate (MgSO4)
onset & duration

A

onset: immediate

duration: 20-30 min with good renal perfusion

31
Q

Magnesium Sulfate (MgSO4)
must be assessing….

A

Deep Tendon Reflexes

32
Q

Magnesium Toxicity Treatment

A

-Ca gluconate 1 gram over 2 min
-fluids
-diuresis
-O2
-Monitor mag levels

32
Q

Magnesium Sulfate (MgSO4)
effect on uterus

A

Relaxes uterus a lot
caution w/ uterine atony/bleeding

33
Q

Mag therapeutic levels

A

4-8
(my Mag & Mesh (CO2) are the same)

34
Q

Mag level when we start to see resp depression

A

10

35
Q

Labetalol in OB

A

few neonatal complications (bradycardia)

alpha & beta antagonist
rapid onset

36
Q

Hydralazine in OB
MoA & side fx

A

decrease maternal BP & uterine vasc resistnce = increase Ut blood flow

Limiting side effects: maternal tachy<3 (SNS reflex to direct vasodilation), vomiting, tremors

37
Q

Hydralazine in OB
vascular effects

A

potent vasodilator:
decrease afterload & PVR (esp if used w/ volume repletion)

38
Q

Nipride
indication

A

acute hypertensive crisis

applies to OB & everybody

39
Q

Nipride
vasc fx

A

potent arteriolar dilator

rapid onset and short duration

40
Q

Nipride in OB

A

concern for maternal/fetal cyanide toxicity

unlikely if low doses 5-10 mcg/kg/min

41
Q

T/F
Nipride is long-acting

A

False
rapid onset and short duration

42
Q

Nitroglycerin (NTG)
MoA
may cause….

A

venodilator
decrease cardiac filling pressures by acting on capacitance vessels

may get reflex tachycardia

43
Q

Volume Repletion (decrease ECF) in OB
uses

A

for severe pre-eclampsia to improve low CO

R & L filling pressures normalize:
-CI improves
-decrease mom’s HR & SVR decrease
-fetal circulation improves

44
Q

Volume Repletion (decrease ECF) in OB
how it works

A

severe preeclampsia = low CO
must replenish intravasc. vol

R & L filling pressures normalize:
-CI improves
-decrease mom’s HR & SVR decrease
-fetal circulation improves

45
Q

Volume Repletion (decrease ECF) + hydralazine

A

decreased peripheral resistance

(hydralazine = potent vasodilator, decreases afterload)

46
Q

Ephedrine vs Neo in OB

A

Neosynephrine is the pressor of choice in OB
maintains fetal pH

ephedrine: wont decrease Ut bld flow but fetal tachy<3 & acidosis

both can treat hypoTN d/t regionals

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